Abstract
BACKGROUND: Chronic ankle instability (CAI) is a common musculoskeletal problem in children, characterized by mechanical instability, perceived instability, and recurrent sprains. Inadequate rehabilitation can cause symptoms to persist, increase the risk of reinjury, and negatively affect long-term quality of life. Research on the rehabilitation of children with CAI concerning ankle stability, running speed, and agility has been limited. Therefore, the Jump Step Kids (JSKs) program was developed as a rhythmic, multidirectional jumping program to improve functional movement and agility in children with CAI. OBJECTIVE: This study aimed to investigate the effects of the JSKs program on functional movement and self-reported outcomes in children aged 7 to 12 years with CAI. METHODS: A stratified, randomized controlled trial was conducted involving 34 school-aged children with CAI. Participants were randomly allocated to either the intervention group (n=17), which underwent the JSKs program supervised by a physiotherapist, or the control group (n=17), which performed a home-based stretching program for ankle instability. Both groups participated in 30-minute sessions, 3 times per week, for 4 weeks. Outcome measurements were the heel raise test (HRT), standing long jump test, 6-meter crossover hop test, the Bruininks-Oseretsky Test of Motor Proficiency-second edition (BOT-2), and the Foot and Ankle Ability Measure questionnaire. Assessments were performed at baseline and after 4 weeks of training. RESULTS: After 4 weeks, both groups improved in the 6-meter crossover hop test (JSKs: mean 6.60, SD 2.47 s; P=.02; and control: mean 6.82, SD 3.45 s; P=.04). The JSKs group performed better than the control group in the HRT (mean 37.88, SD 11.85 repetitions vs mean 27.65, SD 7.65 repetitions; P=.005), whereas the standing long jump test improved in the control group (mean 104.56, SD 21.88 cm to mean 112.05, SD 19.95 cm; P=.04). For BOT-2 outcomes, the 1-legged stationary hop decreased in controls (mean 35.35, SD 5.45 repetitions to mean 30.24, SD 9.21 repetitions; P=.01), with significant between-group differences (mean 38.18, SD 9.53 repetitions vs mean 30.24, SD 9.21 repetitions; P=.02). The 2-legged side hop improved in both groups (JSKs: mean 12.24, SD 4.54 repetitions to mean 25.24, SD 7.40 repetitions; control: mean 11.47, SD 3.81 repetitions to mean 26.53, SD 6.88 repetitions; P<.001). Self-reported outcomes, including Foot and Ankle Ability Measure-Activities of Daily Living and sports scores, did not differ significantly between groups (P>.05). CONCLUSIONS: The 4-week JSKs program improved functional performance in children with CAI compared with the control group in HRT and BOT-2 outcomes, although self-reported function remained unchanged. These findings provide preliminary evidence supporting the potential efficacy of the JSKs program for children with CAI. The program may serve as an addition to conventional therapy to improve physical performance in the pediatric population.